| NPI | 1356315139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO 49631) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME92308) |
| 208600000X Surgery (Licence: FL ME92308) | |
| 2086S0129X Surgery, Vascular Surgery (Licence: FL ME92308) | |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2021-05-20 |